Endgame: Pelosi's Health Care Gamble

by Benjamin Domenech on 3:00 pm March 13, 2010

Pelosi's Endgame


This is it, folks — the health care endgame. Appropriately named Slaughter strategy, come on down!

In addition, it looks like House Democrats won’t have to vote directly on a Senate bill they really don’t like. The speaker hasn’t made a final decision, but she told her rank-and-file during the meeting that the plan now is to craft a rule that would “deem” the Senate bill passed once they approve the package of fixes.

Let’s pull together a few key issues as we go into what is in all likelihood the final week in the runup to the vote within the House of Representatives, a vote that could reshape America’s health policy and economic future.

The first and most important thing to remember: they don’t have the votes right now, but that doesn’t mean they won’t when it comes to the floor. Pelosi can only allow for 37 “No” votes from Democrats, and my current count has her at 45…but we’ll soon see how solid those are.


Rep. Chris Van Hollen (D-MD) sent out this memo regarding the timing and procedures for the coming week. Assume that this is the way things will hash out:

TODAY or MONDAY: CBO will publish final scores on legislative language

THEN: House Budget Committee must approve using the reconciliation process to pass this

THEN: The bill will go to the Rules Committee, rule will be constructed for consideration on the floor, and language will be posted online (on the Rules website) and the 72-hour clock will start. When this happens, we will start to have a better idea on what the process will be.

THEN: A Manager’s Amendment will be constructed that will make some final changes

THEN: The Manager’s Amendment will be posted online and the 72-hour clock will start (this may overlap with the 72-hour clock on the reconciliation language). When Manager’s Amendment is done final process decisions will be locked in.

THIS MEANS: We will likely vote Friday or Saturday. (As you probably saw, POTUS pushed back the departure for his Asian trip from Thursday the 18th to Sunday the 21st; this was not a coincidence.) The Speaker has publically committed to trying to get a vote on both the reconciliation bill and the Senate bill on the same day. They are still trying to work out the final process on this and much of what we do depends on what the Senate Parliamentarian decides. You may be receiving calls about the “Slaughter Rule” and other rumors about what the process will be. Again, please understand: no decision has yet been made on the process for consideration on the House floor.

The Abortion Issue

While this issue has gotten the most press, it’s also the one that has gone almost exactly as expected over the past month: Speaker Nancy Pelosi (D-CA) has refused to budge or to allow a vote on the issue.

Sources tell me that in a meeting last week with Planned Parenthood, Pelosi promised abortion supporters in the strongest possible terms that she would not cut any deal with Rep. Bart Stupak, leader of the pro-life Democrats, on the bill.

This is a significant difference from last November, when Pelosi had merely promised to “do what I can” to keep from letting Stupak’s amendment pass — ultimately relenting when it became clear the bill needed Stupak’s supporters to proceed (or at least to proceed without forcing moderates to support it).

Pelosi’s promise to her hard-core abortion backers is backed up by her actions: she has shut out Stupak from negotiations and will not deal with him, having given up on offering pro-life Democrats even a fig leaf vote where they could express their views.

House Majority Leader Steny Hoyer, D-Md., on Friday told NBC News that striking an abortion deal is out of the question.

“We don’t want to go without their votes but we do want to forge ahead,” Hoyer said about the anti-abortion Democrats.

Hoyer had previously floated the idea of having a sidebar measure which could satisfy pro-life Democrats. Instead, they are writing them off — assuming they will be able to peel off enough of them to pass the bill.

For Stupak’s part, he is clear about what this means for pro-life Democrats in an interview with Robert Costa:

If Obamacare passes, Stupak says, it could signal the end of any meaningful role for pro-life Democrats within their own party. “It would be very, very hard for someone who is a right-to-life Democrat to run for office,” he says. “I won’t leave the party. I’m more comfortable here and still believe in a role within it for the right-to-life cause, but this bill will make being a pro-life Democrat much more difficult. They don’t even want to debate this issue. We’ll probably have to wait until the Republicans take back the majority to fix this.”

Other Issues

The strong late-game push from the left to insert a public option in the legislation came to nought — unsurprisingly — thanks to Nancy Pelosi’s decision, even though it appears that there are enough votes to pass such an option through reconciliation (or at least that it’s within shooting distance).

The side effect of this decision is that the progressive wing of the party will be less eager to put pressure on members to support this bill. This shows in the continued unwillingness of some key committee chairmen to establish their support for the legislation.

One final key sign that the coalition Pelosi has assembled is fragile indeed was the announcement by Rep. Luis Gutierrez (D-IL), a key Latino leader in Congress, that he would oppose the bill. Immigration politics has been injected into the current debate to a greater degree than expected, and Gutierrez’s concerns may have to be addressed.

crossposted at Health Care News.

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